Friedersdorff Frank, Schulz Matthias, Weinberger Sarah, Ramos Scarlet Munayco, Ralla Bernhard, Liefeldt Lutz, Kanne Martin, Sakar Senem, Lerchbaumer Markus H, Schlomm Thorsten, Lichy Isabel, Peters Robert, Schmidt Jacob
Department of Urology, Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Department of Urology, Evangelisches Krankenhaus Koenigin Elisabeth Herzberge, Berlin, Germany.
World J Urol. 2025 Jan 3;43(1):56. doi: 10.1007/s00345-024-05426-y.
The objective of this study was to evaluate the perioperative outcomes and complications associated with the use of acetylsalicylic acid (ASA) in deceased donor kidney transplantation (KTX), with a particular focus on bleeding events.
We retrospectively analyzed 157 kidney transplant recipients (KTRs) who underwent KTX at Charité Berlin, Department for Urology, between February 2014 and December 2017. Patients were divided into two groups: patients with ASA in their preoperative medication (Group A, n = 59) and patients without ASA use (Group B, n = 98). Data on demographic information, medical conditions, surgical details, and postoperative outcomes were analyzed. Complications were classified using the Clavien-Dindo classification. Statistical analyses included t-tests, chi-square tests, and multivariate logistic regression.
Group A had significantly older donors (59.7 ± 12.9 years vs. 52.0 ± 14.1 years, p < 0.001) and a higher incidence of coronary artery disease (42.4% vs. 3.1%, p = 0.001). There were no significant differences in perioperative hemoglobin loss and perioperative bleeding events between the groups, but a tendency towards higher rates of intraoperative bleeding (15.3% vs. 8.2%, p = 0.17) and postoperative transfusions (22% vs. 13.3%, p = 0.15) in Group A. Mortality was higher in Group A (18.6% vs. 4.1%, p = 0.003), with one death attributed to a cardiac event. Kaplan-Meier analysis revealed significantly inferior overall survival for Group A (p = 0.02), but no significant difference in graft survival (p = 0.18).
ASA use is associated with a trend towards increased intraoperative bleeding and postoperative blood transfusion but does not significantly increase major postoperative bleeding complications. Careful perioperative monitoring of patients with ASA is recommended.
本研究的目的是评估在 deceased 供体肾移植（KTX）中使用乙酰水杨酸（ASA）的围手术期结局和并发症，特别关注出血事件。
我们回顾性分析了 2014 年 2 月至 2017 年 12 月期间在柏林夏里特医院泌尿外科接受 KTX 的 157 例肾移植受者（KTRs）。患者分为两组：术前用药中有 ASA 的患者（A 组，n = 59）和未使用 ASA 的患者（B 组，n = 98）。分析了人口统计学信息、医疗状况、手术细节和术后结局的数据。并发症采用 Clavien-Dindo 分类法进行分类。统计分析包括 t 检验、卡方检验和多因素逻辑回归。
A 组供体年龄显著更大（59.7 ± 12.9 岁 vs. 52.0 ± 14.1 岁，p < 0.001），冠状动脉疾病发生率更高（42.4% vs. 3.1%，p = 0.001）。两组之间围手术期血红蛋白损失和围手术期出血事件无显著差异，但 A 组术中出血率（15.3% vs. 8.2%，p = 0.17）和术后输血率（22% vs. 13.3%，p = 0.15）有升高趋势。A 组死亡率更高（18.6% vs. 4.1%，p = 0.003），1 例死亡归因于心脏事件。Kaplan-Meier 分析显示 A 组总体生存率显著更低（p = 0.02），但移植肾生存率无显著差异（p = 0.18）。
使用 ASA 与术中出血和术后输血增加的趋势相关，但不会显著增加术后主要出血并发症。建议对使用 ASA 的患者进行仔细的围手术期监测。
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